How to deal with oral thrush when you're breastfeeding

Breastfeeding your baby can be a great bonding experience for mom and baby, plus breastmilk is excellent nourishment and helps your baby develop a strong immune system. However, if one of you gets a dose of oral thrush, also known as candidiasis, it can make breastfeeding difficult and painful.

Thrush occurs when the balance of ‘good’ and ‘bad’ bacteria in the body (good bacteria prevent thrush from taking hold), is disturbed and there’s an overgrowth of the fungus, candida.

Unfortunately, if you’re breastfeeding, you create just the right environment for thrush to grow, as it needs damp, warm conditions in order to thrive. A perfect example is your baby’s mouth. The problem then is that the thrush is transferred to your nipples when your baby feeds – and so the cycle begins where mom and baby pass thrush back and forth between each other.

Dealing with thrush

“When you have thrush while breastfeeding, it’s important to treat yourself and your baby at the same time. If you don’t do this, the infection will merely be transferred from one to the other, repeatedly,” explains Dr Iqbal Karbanee, a paediatrician who practises in Cape Town (paediq.com).

Your doctor will most likely prescribe anti-fungal drops for your baby (to be put in her mouth) and an antifungal ointment for your nipples. “Treating the nipples with an anti-fungal helps reduce the amount of fungus on the breast before the next feed. In this way you will reduce transmission between mom and baby,” Dr Karbanee says.

Note that you have to treat your baby even if your baby doesn’t show symptoms. Your doctor may also prescribe a tablet for you to be taken orally, which will get rid of thrush.

It’s important to continue treatment, even if it feels much better. Follow your doctor’s instructions for the best results.

It’s also a good idea to rinse your nipples with cool, clear water after each feed and to air-dry them for at least 10 minutes before applying your anti-fungal ointment. Be aware also that you can get thrush more easily if your nipples are tender or if your baby isn’t latching correctly.

Additional tips on how to avoid re-infection

Wash your hands often but don’t use any anti-bacterial soaps and only dry your hands on disposable paper towels.

If you are expressing, be sure to sterilise all the bits belonging to the pump and anything that your baby puts in her mouth. To sterilise: boil the toys and pump parts for 20 minutes per day during treatment. You should also replace bottle nipples and pacifiers after a week.